{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:10:23Z","timestamp":1791227423621,"version":"4.1.0"},"reference-count":40,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2023,7,11]],"date-time":"2023-07-11T00:00:00Z","timestamp":1689033600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Lymphatic filariasis (LF) is a vector-borne parasitic disease which affects 70 million people worldwide and causes life-long disabilities. In Bangladesh, there are an estimated 44,000 people suffering from clinical conditions such as lymphoedema and hydrocoele, with the greatest burden in the northern Rangpur division. To better understand the factors associated with this distribution, this study examined socio-economic and environmental factors at division, district, and sub-district levels.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methodology<\/jats:title>\n<jats:p>A retrospective ecological study was conducted using key socio-economic (nutrition, poverty, employment, education, house infrastructure) and environmental (temperature, precipitation, elevation, waterway) factors. Characteristics at division level were summarised. Bivariate analysis using Spearman\u2019s rank correlation coefficient was conducted at district and sub-district levels, and negative binomial regression analyses were conducted across high endemic sub-districts (n = 132). Maps were produced of high endemic sub-districts to visually illustrate the socio-economic and environmental factors found to be significant.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The highest proportion of rural population (86.8%), poverty (42.0%), tube well water (85.4%), and primary employment in agriculture (67.7%) was found in Rangpur division.<\/jats:p>\n<jats:p>Spearman\u2019s rank correlation coefficient at district and sub-district level show that LF morbidity prevalence was significantly (p&lt;0.05) positively correlated with households without electricity (district r<jats:sub>s<\/jats:sub> = 0.818; sub-district r<jats:sub>s<\/jats:sub> = 0.559), households with tube well water (sub-district r<jats:sub>s<\/jats:sub> = 0.291), households without toilet (district r<jats:sub>s<\/jats:sub> = 0.504; sub-district r<jats:sub>s<\/jats:sub> = 0.40), mean annual precipitation (district r<jats:sub>s<\/jats:sub> = 0.695; sub-district r<jats:sub>s<\/jats:sub> = 0.503), mean precipitation of wettest quarter (district r<jats:sub>s<\/jats:sub> = 0.707; sub-district r<jats:sub>s<\/jats:sub> = 0.528), and significantly negatively correlated with severely stunted children (district r<jats:sub>s<\/jats:sub> = -0.723; sub-district r<jats:sub>s<\/jats:sub> = -0.370), mean annual temperature (district r<jats:sub>s<\/jats:sub> = -0.633.; sub-district r<jats:sub>s<\/jats:sub> = 0.353) and mean temperature (wettest quarter) ((district r<jats:sub>s<\/jats:sub> = -0.598; sub-district r<jats:sub>s<\/jats:sub> = 0.316)<\/jats:p>\n<jats:p>Negative binomial regression analyses at sub-district level found severely stunted children (p = &lt;0.001), rural population (p = 0.002), poverty headcount (p = 0.001), primary employment in agriculture (p = 0.018), households without toilet (p = &lt;0.001), households without electricity (p = 0.002) and mean temperature (wettest quarter) (p = 0.045) to be significant.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>This study highlights the value of using available data to identify key drivers associated with high LF morbidity prevalence, which may help national LF programmes better identify populations at risk and implement timely and targeted public health messages and intervention strategies.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0011457","type":"journal-article","created":{"date-parts":[[2023,7,11]],"date-time":"2023-07-11T17:33:31Z","timestamp":1689096811000},"page":"e0011457","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":15,"title":["Socio-economic and environmental factors associated with high lymphatic filariasis morbidity prevalence distribution in Bangladesh"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2670-7517","authenticated-orcid":true,"given":"Tijana","family":"Williams","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Jahirul","family":"Karim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shihab","family":"Uddin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharmin","family":"Jahan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sultan Mahmood","family":"ASM","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaun P.","family":"Forbes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Hooper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark J.","family":"Taylor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise A.","family":"Kelly-Hope","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,7,11]]},"reference":[{"key":"pntd.0011457.ref001","unstructured":"Lymphatic filariasis. 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